Dopamine dysregulation syndrome in Parkinson’s disease

Abstract

Dopamine dysregulation syndrome (DDS) is an iatrogenic disease developing during dopaminergic therapy. According to the data available in the literature, DDS develops in 3-4% of the Parkinson’s disease (PD) cases. DDS in PD is frequently accompanied by other impulse control disorders (ICD): punding, compulsive shopping, hypersexuality, overeating. 246 patients with PD, of whom 16 (6.4%) were found to have DDS, were examined. The patients’ age was 64±7.4 years. Women (n = 10) more often developed DDS than men (n = 6). The patients mainly suffered from the mixed form of the disease. Stages III and IV were diagnosed in 72 and 22%, respectively. The duration of PD was 12+2.6 years. In the PD patients with DDS, the quality-of-life indicators ranged from 19.8 to 90% (54+20.1%). The equivalent dose of levodopa is 1323.4+299 mg/day. DDS was concurrent with other types of ICD in 4 patients: panding in 2, compulsive shopping and punding in 1, and punding and hypersexuality. The doses of levodopa were corrected in patients receiving high doses of dopaminergic drugs. In the patients with DDS concurrent with punding or hypersexuality, the dose of dopaminergic receptor agonists was gradually reduced and subsequently discontinued.